This document summarizes accounting and finance reporting changes that healthcare organizations need to be aware of, including:
- New guidance on accounting for electronic health record incentives from Medicare and Medicaid.
- Updates to accounting for Recovery Audit Contractor claim adjustments and exposures.
- Clarified auditing standards issued by auditing standard setters.
- Recent updates from FASB including new disclosure requirements for bad debts and allowances as well as accounting for malpractice claims and insurance recoveries.
Financial Management In Healthcare PowerPoint Presentation SlidesSlideTeam
This document discusses various topics related to financial management in healthcare, including:
- Key financial trends in the healthcare industry such as value-based payments and data analytics.
- A comparison of healthcare expenditures as a percentage of GDP across different countries.
- An overview of different healthcare financing models.
- Metrics and analysis used for healthcare system financial analysis including profitability ratios.
- A comparison of hypothetical healthcare organization financial statements under two alternatives.
- Calculations of direct and indirect healthcare costs.
- Various statistics related to healthcare spending, quality, and the size of the global healthcare market.
Chapter 1: Context of Health Care Financial ManagementNada G.Youssef
This document discusses key topics in health care financial management including lowering costs, goals of the health care system, and changing methods of financing and delivery. It outlines reforms under the Affordable Care Act to expand access through insurance marketplaces and Medicaid expansion while controlling costs through value-based purchasing. It also covers trends like the rise of the uninsured and accountable care organizations, as well as factors affecting the cost of care and impacts to provider reimbursement models.
The document discusses components of the revenue cycle in healthcare, including pre-claims submission, claims processing, accounts receivable, claims reconciliation, and collections. It describes the charge description master which houses billing information for healthcare services and supplies. Effective revenue cycle management is important for a provider's financial stability. The revenue cycle involves coordination between many departments to accurately capture and bill for services provided to patients.
Financial management in the health sector involves making decisions about financing, investment, and dividends. It addresses questions like how to fund healthcare, where to invest resources, and what the return on investment is. The key tools of financial management include costing, budgeting, accounting, and auditing. Budgets allocate limited public funds by prioritizing programs and policies. They should be realistic, cover defined activities, and guide resource allocation based on goals. Financial management ensures proper utilization and accountability of funds.
This document provides an overview of financial management in healthcare, including the different views (financial, process, clinical), types of organizations, accounting, and key concepts. The main points are:
1) There are three main views in healthcare - financial (budgets, reporting), process (systems, structure), and clinical (service delivery, outcomes).
2) Healthcare organizations can be for-profit, non-profit voluntary, or non-profit government/mixed.
3) Financial management systems gather data from original records through information and accounting systems to produce reports on revenues, costs, and performance.
4) Key concepts include assets (resources), liabilities (debts), and net worth (value after
This document outlines the 10 steps of the medical billing cycle: 1) preregistering patients, 2) establishing financial responsibility, 3) checking patients in, 4) checking patients out and documenting diagnoses and procedures, 5) reviewing coding for compliance, 6) checking billing compliance, 7) preparing and transmitting insurance claims, 8) monitoring payer adjudication of claims, 9) generating patient statements, and 10) following up on payments and handling collections. It also defines key terms related to medical billing and coding.
Development of Financial Performance Benchmark Of MOPH’s hospitals in ThailandUtoomporn Wongsin
This document outlines a study to establish financial performance benchmarks for hospitals in Thailand. The study analyzed financial statements and key ratios of 821 hospitals to identify benchmarks for expenses, revenues, and metrics like EBITDA, cash ratio, average collection period, average payment period, and service cost. The benchmarks will allow hospital managers and oversight agencies to evaluate financial performance and identify issues. While the model is still being developed, establishing these benchmarks provides a baseline for financial management and planning. Further refining the methodology is recommended to account for variations within hospital types.
This document discusses various aspects of revenue management in healthcare, including the revenue cycle, payment methodologies like Medicare and commercial insurance, and strategies for contract negotiation. It describes the front-end, middle, and back-end of the revenue cycle. It explains payment systems like MS-DRGs, APCs, and fee schedules used by Medicare and common commercial insurers. It also covers topics like contractual allowances, prospective versus retrospective payment, and value-based purchasing.
Financial Management In Healthcare PowerPoint Presentation SlidesSlideTeam
This document discusses various topics related to financial management in healthcare, including:
- Key financial trends in the healthcare industry such as value-based payments and data analytics.
- A comparison of healthcare expenditures as a percentage of GDP across different countries.
- An overview of different healthcare financing models.
- Metrics and analysis used for healthcare system financial analysis including profitability ratios.
- A comparison of hypothetical healthcare organization financial statements under two alternatives.
- Calculations of direct and indirect healthcare costs.
- Various statistics related to healthcare spending, quality, and the size of the global healthcare market.
Chapter 1: Context of Health Care Financial ManagementNada G.Youssef
This document discusses key topics in health care financial management including lowering costs, goals of the health care system, and changing methods of financing and delivery. It outlines reforms under the Affordable Care Act to expand access through insurance marketplaces and Medicaid expansion while controlling costs through value-based purchasing. It also covers trends like the rise of the uninsured and accountable care organizations, as well as factors affecting the cost of care and impacts to provider reimbursement models.
The document discusses components of the revenue cycle in healthcare, including pre-claims submission, claims processing, accounts receivable, claims reconciliation, and collections. It describes the charge description master which houses billing information for healthcare services and supplies. Effective revenue cycle management is important for a provider's financial stability. The revenue cycle involves coordination between many departments to accurately capture and bill for services provided to patients.
Financial management in the health sector involves making decisions about financing, investment, and dividends. It addresses questions like how to fund healthcare, where to invest resources, and what the return on investment is. The key tools of financial management include costing, budgeting, accounting, and auditing. Budgets allocate limited public funds by prioritizing programs and policies. They should be realistic, cover defined activities, and guide resource allocation based on goals. Financial management ensures proper utilization and accountability of funds.
This document provides an overview of financial management in healthcare, including the different views (financial, process, clinical), types of organizations, accounting, and key concepts. The main points are:
1) There are three main views in healthcare - financial (budgets, reporting), process (systems, structure), and clinical (service delivery, outcomes).
2) Healthcare organizations can be for-profit, non-profit voluntary, or non-profit government/mixed.
3) Financial management systems gather data from original records through information and accounting systems to produce reports on revenues, costs, and performance.
4) Key concepts include assets (resources), liabilities (debts), and net worth (value after
This document outlines the 10 steps of the medical billing cycle: 1) preregistering patients, 2) establishing financial responsibility, 3) checking patients in, 4) checking patients out and documenting diagnoses and procedures, 5) reviewing coding for compliance, 6) checking billing compliance, 7) preparing and transmitting insurance claims, 8) monitoring payer adjudication of claims, 9) generating patient statements, and 10) following up on payments and handling collections. It also defines key terms related to medical billing and coding.
Development of Financial Performance Benchmark Of MOPH’s hospitals in ThailandUtoomporn Wongsin
This document outlines a study to establish financial performance benchmarks for hospitals in Thailand. The study analyzed financial statements and key ratios of 821 hospitals to identify benchmarks for expenses, revenues, and metrics like EBITDA, cash ratio, average collection period, average payment period, and service cost. The benchmarks will allow hospital managers and oversight agencies to evaluate financial performance and identify issues. While the model is still being developed, establishing these benchmarks provides a baseline for financial management and planning. Further refining the methodology is recommended to account for variations within hospital types.
This document discusses various aspects of revenue management in healthcare, including the revenue cycle, payment methodologies like Medicare and commercial insurance, and strategies for contract negotiation. It describes the front-end, middle, and back-end of the revenue cycle. It explains payment systems like MS-DRGs, APCs, and fee schedules used by Medicare and common commercial insurers. It also covers topics like contractual allowances, prospective versus retrospective payment, and value-based purchasing.
The resource-based relative value scale (RBRVS) is used to determine reimbursement for professional services under Medicare Part B. RBRVS assigns relative value units (RVUs) to codes based on physician work, practice expense, and malpractice insurance. RVUs are adjusted by geographic practice cost indexes and multiplied by a conversion factor to calculate payment amounts. Correct coding and documentation are essential for full and accurate RBRVS reimbursement. Unnecessary administrative costs associated with health plan management can significantly impact provider revenues.
Practice Valuation & Physician Compensation Planning ConsiderationsPYA, P.C.
PYA Principal Carol Carden and PYA Senior Consultant Katie Culver presented “Practice Valuation and Compensation Planning Considerations" at the TSCPA Southeastern Forensic & Valuation Services Conference.
Accounting Update Overview with a Healthcare SlantPYA, P.C.
PYA Principal and Director of Audit Services Doug Arnold presented during East Tennessee State University’s 38th Annual Accounting, Auditing, and Tax Updating CPE conference. His presentation covered many recent Accounting Standards Updates, but leaned toward their applications in healthcare.
This paper will discuss the most effective and ineffective financial management practices in the healthcare setting. Healthcare is the most difficult industry to prepare financial operating budgets. There are many factors and variables that must be taken into consideration. These factors and variables can change yearly making the preparation of the budget even more difficult.
Evaluation and Management Coding Risk RevisitedPYA, P.C.
PYA Consulting Manager Valerie Rock's presentation covers the factors that impact E/M documentation and coding risk; current issues and concerns surrounding physician documentation; and perspectives and interpretations that can impact coding, education, and auditing.
The document discusses centralized vs decentralized budget preparation in hospital pharmacies. Centralized budget preparation involves the pharmacy department being responsible for all drug procurement, distribution, and control. Decentralized preparation gives this responsibility to individual departments. While decentralized budgets can increase physician awareness and compliance with evidence-based practice, centralized is more efficient and allows leveraging bulk purchasing contracts to minimize costs. Key factors in budget preparation include income/revenue, expenditure on salaries, supplies, drugs, and capital equipment. Implementation considers departmental requirements, funds, costs and monitoring deviations from standards.
Elaj Group is a healthcare organization operating in multiple countries focusing on chronic care delivery. It has medical centers, hospitals, and labs. Elaj uses a combination of generic strategies including cost leadership, differentiation, and focus. Its vision is to provide leading healthcare services in the Middle East and Africa. The mission is to build and operate diagnostic and medical centers/hospitals providing high-quality, affordable services. A PESTEL analysis identified political instability, foreign exchange rate fluctuations, price increases, lifestyle changes, and new technologies as important external factors. Porter's five forces showed competition from other groups, moderate threats from new entrants, and strong supplier relationships.
Healthcare Valuations in an Era of Reform and UncertaintyPYA, P.C.
PYA Principal Jim Lloyd's AICPA Health Care Industry Conference presentation explored reform and current environment highlights, healthcare transactions and affiliations, valuation considerations, and regulatory issues.
PYA Principal Scott Clay presented “Pacing Volume-to-Value Transition” at the AlaHA Annual Meeting, June 8-11, 2016.
The presentation explored volume- to value-based reimbursement, and how the pace of change is unique to each organization. The presentation introduced a strategic framework to establish and communicate a pace of change befitting various organizations, explaining:
How government policies “set the floor” on the degree of change requested.
How to determine the pace of change in your market.
How to identify your organization’s current position and culture in relation to value-based payment models.
How to set and communicate the pace of transition consistent with your market and your organization’s culture.
Determining Value & Physician Compensation When Purchasing a PracticePYA, P.C.
This document discusses considerations for valuing a physician practice and determining physician compensation when a hospital is acquiring the practice. It covers regulatory issues under Stark and anti-kickback laws, common valuation methods including asset-based and income approaches, factors for determining fair market value and commercial reasonableness, and structuring post-acquisition physician employment compensation.
Overcoming Physician Contracting Challenges with MD RangerMD Ranger, Inc.
This document provides an overview of MD Ranger, a platform that offers benchmarks and tools to help healthcare organizations strengthen their physician contracting processes and compliance. It notes the rising costs of physician payments and lists challenges like uncertain fair market value compliance. MD Ranger contains over 250 physician payment benchmarks, contract proposal tools, and reports. It aims to help standardize rates, facilitate data-driven negotiations, and reduce compliance risks through comprehensive benchmark data and documentation. The presentation demonstrates MD Ranger's online platform and discusses how it meets the needs of various organization types such as health systems and small hospitals.
Hot Valuation Issues for Physician AgreementsPYA, P.C.
The document summarizes key issues related to physician compensation agreements and the impact of healthcare reform. It discusses the increased complexity of compensation models with multiple layers and components. Ensuring fair market value and commercial reasonableness of the overall arrangement is important as the sum of individual components could exceed what is reasonable. The presentation also covers analyzing losses, benchmarks, and factors considered in commercial reasonableness determinations. Healthcare continues shifting toward value-based payments, quality incentives, and bundled payments through initiatives like Accountable Care Organizations.
Physician contracting compliance is a serious concern for healthcare executives, attorneys, and compliance professionals. Maintaining compliance of physician contracts requires balancing physician relationships and paying fairly.
This webinar will cover best practices hospital leaders can use to refine their organization's compliance processes, including:
-Educating staff
-Determining and documenting FMV
-Identifying and handling potentially risky contracts
Forensic and Valuation Issues in HealthcarePYA, P.C.
PYA Principal Carol Carden co-presented “Forensic and Valuation Issues in Healthcare” at the AICPA Forensic & Valuation Services Conference in New Orleans, LA, November 10, 2014.
Sustainable Growth Rate? Goodbye for Good!PYA, P.C.
PYA Staff Consultant Aaron Elias spoke to attendees of the Georgia Healthcare Financial Management Association’s (HFMA) Spring Institute May 6, 2015, on the implications of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Best Practices for Increasing Hospital Profitability by Dr.Mahboob Khan PhdHealthcare consultant
Hospitals today face many challenges including an economic recession, increases in uninsured care and growing competition for outpatient services. However, there are still many steps hospitals can take to increase their profitability amid these economic conditions.
Industry experts say that hospitals wishing to increase their profitability can focus on two key areas — reducing costs and increasing reimbursement. Here are 10 best practices for increasing hospital profitability by reducing costs and increasing revenue and reimbursement.
Cost Report Workshops and OMB Uniform Guidance Cost Principles Patrick Huegel
Guidance and best practices in implementing significant changes made to Federally Qualified Health Center (FQHC) Medicare and Medicaid Cost Reports. FQHCs with fiscal year ends beginning after July 1, 2014 must pay particular attention to cost report changes affecting: revenue statistics, determination of full-time equivalent employees (FTE), expenses and visits, settlement amounts, and the calculation of allowable costs.
This document describes an initiative by Catholic Health East (CHE) to implement system-wide Medicare compliance standards across their network of hospitals. A task force developed 12 standards of practice focused on accurate patient status determination and communication between case management, billing, and other departments. A large teaching hospital pilotted the standards, which improved billing timeliness and reduced aged Medicare accounts. All CHE hospitals were then required to implement the standards within 3 months. The standards addressed issues like physician-led utilization reviews, concurrent case management, electronic communication, and data analysis. Overall the goal was to promote early and accurate status assessments to support compliant billing and reimbursement.
Notifications to prescription medicinesTGA Australia
The document discusses notifications for low risk changes to prescription medicines in Australia. It provides an overview of the notifications process, including the use of an electronic form (e-form) to submit notifications. The e-form allows sponsors to search for their medicines, select the relevant entry, choose a notification type, provide assurances, validate changes, attach supporting information and view a summary. Notifications will be incorporated into updated minor variations guidance and the prescription medicines e-form for notifications will be implemented on December 4, 2017 following an IT deployment.
The document discusses 4 dangerous trends facing medical groups: 1) Regulatory and compliance burdens continue to increase with many new regulations and compliance dates in 2015. 2) Operating costs continue to rise significantly each year, especially for staffing which accounts for over half of practice costs. 3) Provider reimbursement is declining from both government and commercial payers, with Medicare payments being cut and penalties increasing. 4) Patient collections have become critical with declining reimbursement. The presentation provides strategies for practices to address these challenges through improving productivity, evaluating costs, and protecting staff.
This document outlines the topics that will be covered in a financial management course for hospital executives. The course will cover fundamental financial management concepts like risks and rates of return, time value of money, and financial assets. It will also cover topics like capital budgeting, capital structure, working capital management, and financial planning. The document notes that financial management involves planning, directing, monitoring, organizing and controlling an organization's monetary resources. It aims to help organizations achieve financial objectives like profitability, risk control, and meeting stakeholder expectations.
WHAT IF: Financial incentives were better aligned across hospital and communi...CFHI-FCASS
This document discusses aligning financial incentives across hospital and community care settings through combining activity-based funding and global budgets. Currently, funding policies are not aligned, creating disincentives for efficient patient flow. The proposed option is blending activity-based funding and global budgets for acute and post-acute care separately. While activity-based funding generally promotes volume and efficiency in hospitals, its impact on costs and capacity in post-acute care is unknown. Transitioning patients between facilities also poses challenges under this model.
The resource-based relative value scale (RBRVS) is used to determine reimbursement for professional services under Medicare Part B. RBRVS assigns relative value units (RVUs) to codes based on physician work, practice expense, and malpractice insurance. RVUs are adjusted by geographic practice cost indexes and multiplied by a conversion factor to calculate payment amounts. Correct coding and documentation are essential for full and accurate RBRVS reimbursement. Unnecessary administrative costs associated with health plan management can significantly impact provider revenues.
Practice Valuation & Physician Compensation Planning ConsiderationsPYA, P.C.
PYA Principal Carol Carden and PYA Senior Consultant Katie Culver presented “Practice Valuation and Compensation Planning Considerations" at the TSCPA Southeastern Forensic & Valuation Services Conference.
Accounting Update Overview with a Healthcare SlantPYA, P.C.
PYA Principal and Director of Audit Services Doug Arnold presented during East Tennessee State University’s 38th Annual Accounting, Auditing, and Tax Updating CPE conference. His presentation covered many recent Accounting Standards Updates, but leaned toward their applications in healthcare.
This paper will discuss the most effective and ineffective financial management practices in the healthcare setting. Healthcare is the most difficult industry to prepare financial operating budgets. There are many factors and variables that must be taken into consideration. These factors and variables can change yearly making the preparation of the budget even more difficult.
Evaluation and Management Coding Risk RevisitedPYA, P.C.
PYA Consulting Manager Valerie Rock's presentation covers the factors that impact E/M documentation and coding risk; current issues and concerns surrounding physician documentation; and perspectives and interpretations that can impact coding, education, and auditing.
The document discusses centralized vs decentralized budget preparation in hospital pharmacies. Centralized budget preparation involves the pharmacy department being responsible for all drug procurement, distribution, and control. Decentralized preparation gives this responsibility to individual departments. While decentralized budgets can increase physician awareness and compliance with evidence-based practice, centralized is more efficient and allows leveraging bulk purchasing contracts to minimize costs. Key factors in budget preparation include income/revenue, expenditure on salaries, supplies, drugs, and capital equipment. Implementation considers departmental requirements, funds, costs and monitoring deviations from standards.
Elaj Group is a healthcare organization operating in multiple countries focusing on chronic care delivery. It has medical centers, hospitals, and labs. Elaj uses a combination of generic strategies including cost leadership, differentiation, and focus. Its vision is to provide leading healthcare services in the Middle East and Africa. The mission is to build and operate diagnostic and medical centers/hospitals providing high-quality, affordable services. A PESTEL analysis identified political instability, foreign exchange rate fluctuations, price increases, lifestyle changes, and new technologies as important external factors. Porter's five forces showed competition from other groups, moderate threats from new entrants, and strong supplier relationships.
Healthcare Valuations in an Era of Reform and UncertaintyPYA, P.C.
PYA Principal Jim Lloyd's AICPA Health Care Industry Conference presentation explored reform and current environment highlights, healthcare transactions and affiliations, valuation considerations, and regulatory issues.
PYA Principal Scott Clay presented “Pacing Volume-to-Value Transition” at the AlaHA Annual Meeting, June 8-11, 2016.
The presentation explored volume- to value-based reimbursement, and how the pace of change is unique to each organization. The presentation introduced a strategic framework to establish and communicate a pace of change befitting various organizations, explaining:
How government policies “set the floor” on the degree of change requested.
How to determine the pace of change in your market.
How to identify your organization’s current position and culture in relation to value-based payment models.
How to set and communicate the pace of transition consistent with your market and your organization’s culture.
Determining Value & Physician Compensation When Purchasing a PracticePYA, P.C.
This document discusses considerations for valuing a physician practice and determining physician compensation when a hospital is acquiring the practice. It covers regulatory issues under Stark and anti-kickback laws, common valuation methods including asset-based and income approaches, factors for determining fair market value and commercial reasonableness, and structuring post-acquisition physician employment compensation.
Overcoming Physician Contracting Challenges with MD RangerMD Ranger, Inc.
This document provides an overview of MD Ranger, a platform that offers benchmarks and tools to help healthcare organizations strengthen their physician contracting processes and compliance. It notes the rising costs of physician payments and lists challenges like uncertain fair market value compliance. MD Ranger contains over 250 physician payment benchmarks, contract proposal tools, and reports. It aims to help standardize rates, facilitate data-driven negotiations, and reduce compliance risks through comprehensive benchmark data and documentation. The presentation demonstrates MD Ranger's online platform and discusses how it meets the needs of various organization types such as health systems and small hospitals.
Hot Valuation Issues for Physician AgreementsPYA, P.C.
The document summarizes key issues related to physician compensation agreements and the impact of healthcare reform. It discusses the increased complexity of compensation models with multiple layers and components. Ensuring fair market value and commercial reasonableness of the overall arrangement is important as the sum of individual components could exceed what is reasonable. The presentation also covers analyzing losses, benchmarks, and factors considered in commercial reasonableness determinations. Healthcare continues shifting toward value-based payments, quality incentives, and bundled payments through initiatives like Accountable Care Organizations.
Physician contracting compliance is a serious concern for healthcare executives, attorneys, and compliance professionals. Maintaining compliance of physician contracts requires balancing physician relationships and paying fairly.
This webinar will cover best practices hospital leaders can use to refine their organization's compliance processes, including:
-Educating staff
-Determining and documenting FMV
-Identifying and handling potentially risky contracts
Forensic and Valuation Issues in HealthcarePYA, P.C.
PYA Principal Carol Carden co-presented “Forensic and Valuation Issues in Healthcare” at the AICPA Forensic & Valuation Services Conference in New Orleans, LA, November 10, 2014.
Sustainable Growth Rate? Goodbye for Good!PYA, P.C.
PYA Staff Consultant Aaron Elias spoke to attendees of the Georgia Healthcare Financial Management Association’s (HFMA) Spring Institute May 6, 2015, on the implications of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Best Practices for Increasing Hospital Profitability by Dr.Mahboob Khan PhdHealthcare consultant
Hospitals today face many challenges including an economic recession, increases in uninsured care and growing competition for outpatient services. However, there are still many steps hospitals can take to increase their profitability amid these economic conditions.
Industry experts say that hospitals wishing to increase their profitability can focus on two key areas — reducing costs and increasing reimbursement. Here are 10 best practices for increasing hospital profitability by reducing costs and increasing revenue and reimbursement.
Cost Report Workshops and OMB Uniform Guidance Cost Principles Patrick Huegel
Guidance and best practices in implementing significant changes made to Federally Qualified Health Center (FQHC) Medicare and Medicaid Cost Reports. FQHCs with fiscal year ends beginning after July 1, 2014 must pay particular attention to cost report changes affecting: revenue statistics, determination of full-time equivalent employees (FTE), expenses and visits, settlement amounts, and the calculation of allowable costs.
This document describes an initiative by Catholic Health East (CHE) to implement system-wide Medicare compliance standards across their network of hospitals. A task force developed 12 standards of practice focused on accurate patient status determination and communication between case management, billing, and other departments. A large teaching hospital pilotted the standards, which improved billing timeliness and reduced aged Medicare accounts. All CHE hospitals were then required to implement the standards within 3 months. The standards addressed issues like physician-led utilization reviews, concurrent case management, electronic communication, and data analysis. Overall the goal was to promote early and accurate status assessments to support compliant billing and reimbursement.
Notifications to prescription medicinesTGA Australia
The document discusses notifications for low risk changes to prescription medicines in Australia. It provides an overview of the notifications process, including the use of an electronic form (e-form) to submit notifications. The e-form allows sponsors to search for their medicines, select the relevant entry, choose a notification type, provide assurances, validate changes, attach supporting information and view a summary. Notifications will be incorporated into updated minor variations guidance and the prescription medicines e-form for notifications will be implemented on December 4, 2017 following an IT deployment.
The document discusses 4 dangerous trends facing medical groups: 1) Regulatory and compliance burdens continue to increase with many new regulations and compliance dates in 2015. 2) Operating costs continue to rise significantly each year, especially for staffing which accounts for over half of practice costs. 3) Provider reimbursement is declining from both government and commercial payers, with Medicare payments being cut and penalties increasing. 4) Patient collections have become critical with declining reimbursement. The presentation provides strategies for practices to address these challenges through improving productivity, evaluating costs, and protecting staff.
This document outlines the topics that will be covered in a financial management course for hospital executives. The course will cover fundamental financial management concepts like risks and rates of return, time value of money, and financial assets. It will also cover topics like capital budgeting, capital structure, working capital management, and financial planning. The document notes that financial management involves planning, directing, monitoring, organizing and controlling an organization's monetary resources. It aims to help organizations achieve financial objectives like profitability, risk control, and meeting stakeholder expectations.
WHAT IF: Financial incentives were better aligned across hospital and communi...CFHI-FCASS
This document discusses aligning financial incentives across hospital and community care settings through combining activity-based funding and global budgets. Currently, funding policies are not aligned, creating disincentives for efficient patient flow. The proposed option is blending activity-based funding and global budgets for acute and post-acute care separately. While activity-based funding generally promotes volume and efficiency in hospitals, its impact on costs and capacity in post-acute care is unknown. Transitioning patients between facilities also poses challenges under this model.
LK Solutions, Inc. provides integrity, accuracy, and honesty in financial performance and recovery services. With over 17 years of experience, LK Solutions aims to outperform financial expectations through proven methods. Services include contingency-based underpayment recoveries, contract reviews, revenue code enhancements, and executive summaries to maximize reimbursement. LK Solutions has achieved over $30 million in recoveries for various health systems across the country through specialized services in areas like cardiac care, orthopedics, and pharmacy.
Here at Financial Hospital we build a solid foundation for you to reach your desired destiny of financial stability through proper foundation and execution of financial planning as well as financial goals. As ever, we would like to be a part of your success. Since 2004, Financial Hospital has successfully serviced each and every client's from India or abroad. Be it Financial Planning, Tax advice or investment planning in equity, debt or alternate category; our team backed by strong research and latest economic trends, are always ready to serve our beloved investor's any queries or needs. Today, with the rich experience of our professional team comprise of CA's, MBA''s, CFP's and other technocrats, a thorough knowledge of the markets, strong leadership, innovative and focused research and having 7 office across India, Financial Hospital itself defines its value and success story.
A step-by-step methodology to evaluate a department's revenue stream. Identifiy and assess mission-critical revenue trends to prompt remedies and compromises that maintain the revenue stream.
Hm 2012 session ii – hospital board governancedrbhutto
The document discusses hospital board governance, including the roles and responsibilities of hospital boards, relevant tools like balanced scorecards and dashboards, competencies needed by board members, and challenges facing hospital boards. It provides suggested best practices for boards related to composition, roles, involvement in strategic decisions, access to information, performance evaluation, and oversight.
In manufacturing industrial the world be gotten registers requirement who shall be accomplished to
do named production process bill of materials which is: Component or goods list to process the
need or manufacturing to meet the need firm, that bill of material gets at suiting by totals
production requirement that will be needed to result finished goods or an a half so appropriate from
its requirement each firm.
On manufacturing industry in big scale, as corporate as automotive : car or motorbike exists
hundreds even thousands goods / components to form cars or that motorbike, Then how to control
it? which is with bill of significant or goods order list.
This document discusses financial management and provides an overview of funds flow statements. It defines financial management as dealing with the management of money matters. It also defines funds flow statements as statements that show the movement of funds and the sources and applications of funds for a business over a period of time. Funds flow statements are important as they help business owners and investors understand the incoming and outgoing cash flows of a business and assess its financial standing over time. The objectives of preparing funds flow statements are to analyze the movement of funds between balance sheet dates and identify changes in working capital elements.
This document discusses the computerization of hospital management information systems through information technology developments. It covers major areas of IT development like hardware, software, and information systems design. The focus is on using current technologies to improve the effectiveness and efficiency of managing healthcare institutions. Specific areas that can be computerized are discussed, like patient services and management systems. Critical components of developing an integrated patient-based health information system and the organization's management information system are outlined, including conceptual frameworks, recommended approaches, and considerations around database design.
Hm 2012 session-iii planning & developing a hospitaldrbhutto
The document discusses planning and designing a new hospital or department. It covers conducting a feasibility study to determine needed facilities and services. The study should assess the local patient population, existing competition, and financial viability. It also provides guidelines on hospital size based on catchment population, occupancy rates, and average length of stay. Additional sections cover factors like location, access, flexibility, and allocating space between patient areas, support services and more.
The document discusses the importance of cash flow projections for managing finances and avoiding running out of cash. It explains that a cash flow projection looks ahead to see if there will be enough incoming cash to meet outgoing expenses. There are four components to a cash flow projection: beginning balance, incoming cash from operations/investments/financing, outgoing cash, and ending balance. Having a cash flow projection warns of potential cash flow problems in advance so businesses can take actions like reducing spending or increasing income to avoid running out of money.
This document provides an introduction to clinical pharmacy presented by Ian and Judith Coombes to students in Sri Lanka. In 3 sentences:
The presentation discusses the role of clinical pharmacy in improving patient care by identifying and resolving medication-related issues, outlines differences between healthcare systems in Australia and Sri Lanka, and emphasizes the need for pharmacists to adopt a patient-centered approach through effective communication and consultation to optimize drug therapy and prevent adverse events.
John Hopkins Hospital Financial Summary and AnalysisFozia Yousaf
The Johns Hopkins Hospital has a mission to set the standard of excellence in patient care and improve health globally. It provides top-ranked specialty care like neurosurgery and endoscopy. While its financial ratios showed strong performance in 2011, its debt ratio increased to 65% by 2012 due to investments in new facilities and technology. To maintain its leadership, Johns Hopkins aims to continue providing language services to patients and partnering with insurers while reducing debt through strategic sourcing.
The document provides tips for small businesses to improve cash flow management. It recommends extending payment terms and improving cash collection. It also suggests analyzing expenditures and forecasting cash flow regularly. Some key tips include keeping only key suppliers, paying suppliers on time, offering discounts for early payment, pursuing outstanding debts weekly, and ending relationships with customers with poor payment histories. The document stresses the importance of forecasting cash flow at least weekly and reviewing forecasts against bank statements to improve over time.
Hospital and Healthcare System Strategic Planning and Financial ForecastingAxiom EPM
Given the level of uncertainty in the healthcare industry and all of the external factors that impact healthcare provider organizations today, strategic planning has become an increasingly complex function. The process is no longer a simple financial forecasting exercise. Instead, it has evolved into a more integrated financial and operational planning activity that touches the entire organization. The process of defining a multi-year financial forecast is now predicated on the modeling of individual business initiatives focused on cost reduction or revenue growth. These slides present four factors vital to establishing more agile strategic planning models. You'll learn techniques to incorporate financial and service line-based analytics to enable efficient ‘what-if’ modeling, scenario analysis and initiative-based modeling and tracking.
This document discusses Bills of Materials (BOM) in Tally. A BOM is a list of components required to manufacture a finished good along with their quantities. In Tally, a BOM can be created for stock items that are assembled in-house by specifying a component list when creating or altering a stock item master. The document provides steps to create a stock item for pens and define its BOM to show it requires 3 components each in a quantity of 1. Manufacturing and stock journals can then be used to consume components and produce finished goods based on the defined BOMs. Reports like stock summary and financial statements can then show inventory and production details.
Entering the Final Stretch - Preparing for New Affordable Care Act ObligationsPSOW
This document summarizes a presentation on how the Affordable Care Act will affect emergency medical organizations as employers and providers. Key points include:
- As employers, emergency organizations with 50 or more full-time employees must comply with "pay or play" rules starting in 2015, which require offering affordable health insurance or paying penalties.
- As providers, emergency organizations will face increased fraud enforcement from expanded oversight and penalties under the ACA. The Office of Inspector General will examine Medicare claims data and review transports for medical necessity.
- All non-grandfathered health plans must cover essential health benefits, including emergency transport services. Presenters advise emergency organizations to understand and prepare for new ACA obligations and opportunities.
View the Webinar Here! https://compliatric.com/continuous-compliance-chapter-16-billing-and-collections/
Compliatric is excited to host another session in their “Continuous Compliance" Webinar Series based on the existing Health Center Compliance Manual and the most recently updated Site Visit Protocol. Each month, program requirements are reviewed to assist health centers in understanding the various elements and ensuring continuing compliance. Participants will be able to use these webinars to increase their knowledge of the requirements, and go one step further and utilize the program requirements to improve operational excellence.
This month’s webinar will focus on the following chapter:
Chapter 16: Billing and Collections
Webinar attendee takeaways will include:
· An understanding of the program requirements, which includes updates to the Site Visit Protocol
· Maintaining continuous compliance - not only based on a site visit
· Improving operational excellence for your Community Health Center
Session 1 - audit, accounting and general update September 2023 slidesFelixPerez547899
This session covers a wide range of topics, including the latest on audit, accounting, tax, and vat issues, governance, the next Charity SORP, key Charity Commission and Fundraising Regulator updates and the latest topical issues and how these will impact your organisation. In addition, our in house employment law specialists will give an update on important issues affecting the sector.
Session 1 – Audit, Accounting and general sector round up
Valuation of Physician Practices - David Cranford, Shannon FarrDecosimoCPAs
This document provides an overview of key concepts related to physician practice valuation, including:
- It discusses three common payment methods used by health plans to pay physicians: fee-for-service, discounted fee-for-service, and capitation.
- It outlines various payment adjustments health plans may make like withholds, utilization targets, and bonuses.
- It identifies important revenue and expense items to consider like CPT coding, non-physician staff costs, rent, insurance, and more.
- Key factors that can impact revenues are also outlined such as changes in payor methodologies, payment delays, high deductible plans, and credit balances.
The document provides valuation professionals with background information
Dynamic Changes Occurring: OMB's Uniform Grant GuidanceStreamLinkSoftware
At this year’s National Association of State Auditors, Comptrollers and Treasurers (NASACT) Annual Conference in Chicago, Illinois, StreamLink Software CEO, Adam Roth, and partner at accounting firm Plante Moran, Michelle Watterworth, presented on UGG’s impact on grant administration and audits.
This webinar will provide a summary of key points of the new revenue standard, including updates from the AICPA’s revenue recognition task force. This presentation will include a discussion of the five steps of the new revenue model and application to various industries including construction, manufacturing, nonprofits and healthcare.
The document discusses the FASB's disclosure requirements for short-duration insurance contracts and provides guidance on implementation. It covers topics such as aggregation of disclosures, claims development information, claims frequency data, discounted reserves, and changes to reserving methodologies. It notes some of the challenges in applying the requirements to health insurance contracts and provides best practices for insurers.
Overview of Auditing PPT.pdf And Auditing tips for maximizing intrestwokiletadesa1234
This document provides an overview of rules governing audits in Ethiopia, including requirements for auditors' appointment, remuneration, removal, resignation, eligibility, registration, training, regulation, monitoring, supervision, ethics, and legal liability. It discusses listing, explaining, and criticizing these rules in detail, citing the relevant documents. It also contains lecture slides on topics like the nature and process of auditing, reasons for auditing, distinguishing auditing from accounting, assurance services, types of audits and auditors, and auditor ethics and legal responsibilities. The document is from an "Advanced Auditing and Assurance" course and contains information intended to describe auditing and its requirements.
The document provides an overview and summary of several accounting standards updates (ASUs) issued by the FASB in 2014 that are relevant for private companies and other entities. It discusses the ASUs on simplifying goodwill accounting, interest rate swap accounting, applying variable interest entity guidance to common control leasing arrangements, and other topics. The ASUs aim to reduce costs and complexity for private companies while still providing useful information to financial statement users. The document outlines the objectives, who is affected, key provisions, differences from previous guidance, and effective dates of each ASU.
SterlingRisk - Tackling ACA Reporting Feb 2014ntoscano50
This document summarizes a webinar about the Affordable Care Act's (ACA) employer and provider reporting requirements. It discusses recent legal developments impacting the ACA, an overview of Code Sections 6055 and 6056 which establish reporting for health insurance providers and applicable large employers. It also outlines the general reporting methods required, simplified reporting options, handling of qualifying offers, multiemployer plans, and penalty relief for 2015.
Top 10 Medical Billing KPIs That Show Where Your Practice is Losing MoneyKareo
Kareo’s Billing Subject Matter Expert, Terri Joy, MBA, CPC, CGSC, COC, CPC-I, shares the 10 medical billing KPIs you need to know to prevent your practice from losing money.
Update on accounting and audit 2022(14904885_1).PPTXFelixPerez547899
The document provides an update on various accounting, audit, and regulatory changes affecting charities. Key points include: revised ISAs 315 and 240 which will require auditors to obtain more evidence on risks, controls, and fraud; changes to the audit of defined benefit pension schemes; anticipated revisions to the SORP and Charities SORP in 2024 and 2025; and Charity Commission updates including revised guidance on investments (CC14) and internal controls (CC8). It also discusses the Kids Company report and other areas like new FRS 102, carbon reporting, and the emerging IFR4NPO framework.
This document provides an overview of auditing and assurance services. It defines auditing and distinguishes it from accounting. It describes different types of audits, the need for auditing, and the framework of auditing. It discusses the benefits of financial statement audits, limitations of external audits, and the development of auditing over time. It also covers topics like the principal-agent relationship in auditing, major corporate accounting crises, roles of auditors and users, requirements for becoming an approved company auditor in Malaysia, and the Sarbanes-Oxley Act passed after the Enron scandal.
Setting Your Business Up for MIPS Success in 2019Kareo
In this webinar, Sr. Training Specialist, Marina Verdara, will provide you with the information and tools you need to ensure that your business avoids receiving penalties related to MACRA.
Marina will:
-Provide an in-depth analysis of MACRA, including APM and MIPS
-Review the four MIPS reporting categories and how your business can meet each of their individual requirements
-Recommend industry best practices so both independent medical practices and billing companies can avoid penalties in 2019
Mastering Medical Billing In Kentucky Answers To Common Billing Questions.pptxRichard Smith
Medisys Data Solutions (MDS) understand the challenges that healthcare professionals face when it comes to medical billing and coding in Kentucky. The complex landscape of billing regulations, ever-evolving guidelines, and the need for compliance can be overwhelming. That’s why we’re here to offer our comprehensive medical billing and coding services tailored specifically to meet the needs of healthcare providers in Kentucky.
Mastering Medical Billing In Kentucky Answers To Common Billing Questions.pdfRichard Smith
Medisys Data Solutions (MDS) understand the challenges that healthcare professionals face when it comes to medical billing and coding in Kentucky. The complex landscape of billing regulations, ever-evolving guidelines, and the need for compliance can be overwhelming. That’s why we’re here to offer our comprehensive medical billing and coding services tailored specifically to meet the needs of healthcare providers in Kentucky.
This document is a resume for Sandra Alayne Reistad, who has over 20 years of experience in roles such as internal auditor, operations manager, call center manager, business analyst, accountant, and personnel manager. She has delivered solutions that improved business operations in areas like financial control, receivables management, call center management, business process re-engineering, financial reporting, and software application design.
Similar to hfma hospital financial management (20)
Understanding how timely GST payments influence a lender's decision to approve loans, this topic explores the correlation between GST compliance and creditworthiness. It highlights how consistent GST payments can enhance a business's financial credibility, potentially leading to higher chances of loan approval.
Falcon stands out as a top-tier P2P Invoice Discounting platform in India, bridging esteemed blue-chip companies and eager investors. Our goal is to transform the investment landscape in India by establishing a comprehensive destination for borrowers and investors with diverse profiles and needs, all while minimizing risk. What sets Falcon apart is the elimination of intermediaries such as commercial banks and depository institutions, allowing investors to enjoy higher yields.
5 Tips for Creating Standard Financial ReportsEasyReports
Well-crafted financial reports serve as vital tools for decision-making and transparency within an organization. By following the undermentioned tips, you can create standardized financial reports that effectively communicate your company's financial health and performance to stakeholders.
In a tight labour market, job-seekers gain bargaining power and leverage it into greater job quality—at least, that’s the conventional wisdom.
Michael, LMIC Economist, presented findings that reveal a weakened relationship between labour market tightness and job quality indicators following the pandemic. Labour market tightness coincided with growth in real wages for only a portion of workers: those in low-wage jobs requiring little education. Several factors—including labour market composition, worker and employer behaviour, and labour market practices—have contributed to the absence of worker benefits. These will be investigated further in future work.
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Independent Study - College of Wooster Research (2023-2024) FDI, Culture, Glo...AntoniaOwensDetwiler
"Does Foreign Direct Investment Negatively Affect Preservation of Culture in the Global South? Case Studies in Thailand and Cambodia."
Do elements of globalization, such as Foreign Direct Investment (FDI), negatively affect the ability of countries in the Global South to preserve their culture? This research aims to answer this question by employing a cross-sectional comparative case study analysis utilizing methods of difference. Thailand and Cambodia are compared as they are in the same region and have a similar culture. The metric of difference between Thailand and Cambodia is their ability to preserve their culture. This ability is operationalized by their respective attitudes towards FDI; Thailand imposes stringent regulations and limitations on FDI while Cambodia does not hesitate to accept most FDI and imposes fewer limitations. The evidence from this study suggests that FDI from globally influential countries with high gross domestic products (GDPs) (e.g. China, U.S.) challenges the ability of countries with lower GDPs (e.g. Cambodia) to protect their culture. Furthermore, the ability, or lack thereof, of the receiving countries to protect their culture is amplified by the existence and implementation of restrictive FDI policies imposed by their governments.
My study abroad in Bali, Indonesia, inspired this research topic as I noticed how globalization is changing the culture of its people. I learned their language and way of life which helped me understand the beauty and importance of cultural preservation. I believe we could all benefit from learning new perspectives as they could help us ideate solutions to contemporary issues and empathize with others.
Economic Risk Factor Update: June 2024 [SlideShare]Commonwealth
May’s reports showed signs of continued economic growth, said Sam Millette, director, fixed income, in his latest Economic Risk Factor Update.
For more market updates, subscribe to The Independent Market Observer at https://blog.commonwealth.com/independent-market-observer.
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Abhay Bhutada, the Managing Director of Poonawalla Fincorp Limited, is an accomplished leader with over 15 years of experience in commercial and retail lending. A Qualified Chartered Accountant, he has been pivotal in leveraging technology to enhance financial services. Starting his career at Bank of India, he later founded TAB Capital Limited and co-founded Poonawalla Finance Private Limited, emphasizing digital lending. Under his leadership, Poonawalla Fincorp achieved a 'AAA' credit rating, integrating acquisitions and emphasizing corporate governance. Actively involved in industry forums and CSR initiatives, Abhay has been recognized with awards like "Young Entrepreneur of India 2017" and "40 under 40 Most Influential Leader for 2020-21." Personally, he values mindfulness, enjoys gardening, yoga, and sees every day as an opportunity for growth and improvement.
[4:55 p.m.] Bryan Oates
OJPs are becoming a critical resource for policy-makers and researchers who study the labour market. LMIC continues to work with Vicinity Jobs’ data on OJPs, which can be explored in our Canadian Job Trends Dashboard. Valuable insights have been gained through our analysis of OJP data, including LMIC research lead
Suzanne Spiteri’s recent report on improving the quality and accessibility of job postings to reduce employment barriers for neurodivergent people.
Decoding job postings: Improving accessibility for neurodivergent job seekers
Improving the quality and accessibility of job postings is one way to reduce employment barriers for neurodivergent people.
1. Accounting and Finance Reporting
Changes: What Your Healthcare
Organization Needs to Know
Tyler Bernier, CPA
August 16, 2013
www.eidebai lly.com
2. Agenda
•
EHR Incentives
• RAC and Similar Accruals
• Clarified Audit Standards
• FASB Update
•
•
•
•
Bad debt expense and allowance disclosures
Malpractice claims
Charity care disclosure
Other Updates
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3. Agenda
•
GASB Update
•
GASB codification and clarification
• Reporting entity and component units
• Financial reporting – Deferred inflows and outflows
and net position
• Pension plans – employer accounting
• Other GASB updates
•
Proposed Changes
•
•
Lease Accounting – FASB/IASB
Single Audit
www.eidebai lly.com
4. Electronic Health Records
•
Incentives from both Medicare and Medicaid
•
Current guidance
•
•
•
AICPA - preliminary conclusion
SEC - additional guidance
White Paper by Health Care Expert Panel/HFMA
www.eidebai lly.com
5. Electronic Health Records
•
Medicare reimbursement
•
Demonstrate meaningful use
•
•
•
•
90 consecutive days – year 1
Within a Federal Fiscal Year
Maintain meaningful use and attest annually
Medicaid reimbursement
•
Varies by state
•
•
Idaho: attestation similar to Medicare – 50/40/10 payments
Some states reimburse before meeting meaningful use
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6. Electronic Health Records
•
AICPA/HFMA white paper
•
•
•
•
Not approved by SEC, FASB, GASB, others
―Reasonable assurance‖
Cliff or ratable method
Recommended revenue location:
•
•
•
In performance indicator
Separate from patient revenue
Generally, operating
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7. Electronic Health Records
•
SEC Method/Model
•
•
―Gain contingency‖ - delays recognition
Relevant Accounting Considerations
•
Gain contingency
• Revenue recognition
• Matching
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8. Electronic Health Records
•
Medicare EHR reimbursement treatment
method
•
Revenue recognition method - PPS
•
•
•
•
Record upon attestation
Record upon receipt – more conservative approach
Record when final calculation available – most conservative
Recommend - other operating
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9. Electronic Health Records
•
Medicare EHR reimbursement treatment
method
•
Revenue recognition method - CAH
•
Same as PPS, except option to defer revenue
• Based on matching concept
• Defer based on avg. lives of related EHR equipment or 4 years
•
•
Recommend - other operating
Other Considerations
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10. Electronic Health Records
•
Impact
•
•
•
Potential for change if authoritative guidance is
released
If not deferred for CAH, operating revenues will be
overstated in year 1 and understated in future years
based on recognition of expenses
Without authoritative guidance, disclosure of policy is
most important aspect
www.eidebai lly.com
11. Electronic Health Records
•
DISCLAIMER
•
•
•
There is no authoritative guidance
Treatment will need to be analyzed on an individual
entity basis
Result should reasonably follow authoritative
guidance framework
www.eidebai lly.com
12. RAC and Similar Accruals
HFMA Principles and Practices (P&P) Board
Issue Analysis, ―Accounting for RAC Audit
Adjustments and Exposures‖
•
Accounting for Recovery Audit Contractor (RAC)
audit settlement liabilities
• Potentially relates to other audit contractors –
MIC, MAC, ZPIC, etc.
www.eidebai lly.com
13. RAC and Similar Accruals
•
Applicable situations
•
Notification of RAC audit adjustments
• Notification of a RAC audit adjustment recovery
• Billing and/or payment for services that are potentially
non-reimbursable
• Concerned about RAC audit adjustments not yet
identified
www.eidebai lly.com
14. RAC and Similar Accruals
•
RAC adjustments represent persuasive
evidence that criteria for revenue recognition
have not been met
•
Liability and contractual adjustment in period of
notification
• Consideration of causes of adjustments and whether
they apply to other accounts within the scope (lookback period) of RAC audits
• Consider potentially successful appeals
www.eidebai lly.com
15. RAC and Similar Accruals
•
RAC adjustments
•
For positive adjustments (receivables),
•
•
Only recorded once finalized through CMS
Gain contingency accounting
•
Changes in estimates recorded in current period
• Apply historical take-backs to future claims, unless
process is corrected
www.eidebai lly.com
16. RAC and Similar Accruals
•
Reserves should be based on specific
identification
•
•
Don’t duplicate reserves already made
General reserves should not be recorded
•
•
SOP 00-1 – ―Auditing Health Care Third Party
Reserve and Related Receivables‖
Other entity experience only applies if operating and
billing procedures are identical
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17. RAC and Similar Accruals
•
Impacts
•
Review reserves to determine if they are specifically
identified and calculated or general in nature
• Identify root cause of RAC adjustments and whether
they apply to existing balances
• Potential identification of billing/documentation issues
resulting in self-reporting
•
Discuss with legal counsel, if discovered
www.eidebai lly.com
18. Clarified Audit Standards
•
Combination, re-organization, and clarification
of existing standards
•
•
Some new matters incorporated
Why does this matter to you as the provider?
www.eidebai lly.com
19. Clarified Audit Standards
•
Group Audit Requirements
•
•
•
Definition of group audit
Identification of components
Impacts on You
•
•
•
Increased communications
Potentially lowered testing scopes
Potentially expanded scope of testing
www.eidebai lly.com
20. Clarified Audit Standards
•
Updated audit opinions
•
•
•
Additional paragraphs
Titles included
―Unmodified‖ vs. ―unqualified‖
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22. Bad Debts and Allowance
ASU 2011-07 – ―Presentation and Disclosure of
Patient Service Revenue, Provision of Bad
Debts and the Allowance for Doubtful Accounts
for Certain Health Care Entities‖
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23. Bad Debts and Allowance
•
Affects HC entities that ―recognize significant
amounts of patient service revenue at the time
services are rendered even though the entities
do not assess a patient’s ability to pay.‖
•
Effective for first annual period ending after
December 15, 2012
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24. Bad Debts and Allowance
•
Provision for bad debts associated with patient
service revenue will be transferred from an
operating expense to a deduction from net
patient service revenue.
•
Other bad debts - still an operating expense
• Presented on a separate line after NPSR
www.eidebai lly.com
25. Bad Debts and Allowance
Example Disclosure from Accounting Standards Update:
www.eidebai lly.com
26. Bad Debts and Allowance
•
Disclosures
•
Policy for assessing the timing and amount of
uncollectible patient service revenue recognized as
bad debts by major payor source of revenue
•
•
Major payor sources shall be identified by the entity consistent with how the entity manages its business
Example per standard:
Third-party payors
Self-pay
Total all payors
www.eidebai lly.com
27. Bad Debts and Allowance
•
Disclosures
•
Qualitative and quantitative information about
significant changes in the allowance for doubtful
accounts
•
•
•
•
Significant changes in estimates and underlying assumptions
The amount of self-pay write offs
The amount of third-party payor write offs
Other unusual transactions impacting the allowance for
doubtful accounts
www.eidebai lly.com
28. Bad Debts and Allowance
•
Disclosures
•
Two examples in the ASU provide a detailed example
of expected disclosures
•
•
Includes charity care and/or uninsured discount policies
Also includes allowance for doubtful accounts in third-party
payor accounts
www.eidebai lly.com
29. Bad Debts and Allowance
•
Impacts on certain financial ratios:
Improved
Operating and Total Margins
Days Cash on Hand
**Net Days in Accounts Receivable (depending on
which net revenue is used for calculation)
•
More transparency in allowance disclosures
www.eidebai lly.com
30. Malpractice Claims
ASU 2010-24 – ―Health Care Entities (Topic 954)
Presentation of Insurance Claims and Related
Insurance Recoveries‖
•
Requires that insurable risk claims be recorded
gross - insurance liability and insurance
recovery receivable, if applicable
•
Record based on contingency accounting
• Analyze receivable for collectibility
www.eidebai lly.com
31. Malpractice Claims
•
Types of Insurance
•
•
•
•
Malpractice Insurance
Workers’ Compensation
Health/Dental Insurance
Types of Coverage
•
Claims made policies
• Excess insurance coverage
• Umbrella coverage, etc.
www.eidebai lly.com
32. Malpractice Claims
•
Impacts:
•
•
•
Limited, if any expected impact on income statement
Potential additional liabilities on balance sheet
Meaning of recording a liability?
•
•
•
•
•
Legal counsel
Insurance agency
Board
If material, disclosures necessary
Fiscal years beginning after December 15,
2010
www.eidebai lly.com
33. Goodwill and Intangibles Impairment
ASU 2010-28 – ―Intangibles --- Goodwill and
Other‖
• ASU 2011-08 – ―Intangibles—Goodwill and
Other (Topic 350) Testing Goodwill for
Impairment‖
•
•
ASU 2012-02 – ―Intangibles – Goodwill and
Other‖
www.eidebai lly.com
34. Goodwill and Intangibles Impairment
ASU 2010-28 – Goodwill Impairment
•
If goodwill has zero or negative carrying amounts,
step 1 may be skipped as fair value is expected
to exceed $0.
•
Entity is still required to complete Step 2 of
impairment test if it is more likely than not that a
goodwill impairment exists.
•
Effective – beginning after 12/15/11
www.eidebai lly.com
35. Goodwill and Intangibles Impairment
ASU 2011-08 – Goodwill Impairment
•
Optional pre-step 1 assessment
• Qualitative assessment of goodwill
•
•
•
More-likely-than-not impairment analysis
Several factors listed in ASU to consider for
analysis
Effective - beginning after 12/15/11
www.eidebai lly.com
36. Goodwill and Intangibles Impairment
ASU 2012-02 – Intangibles Impairment
•
Relates to indefinite-lived intangible assets, other
than goodwill
•
Qualitative assessment of goodwill, similar to new
goodwill analysis – more-likely-than-not
•
Effective - beginning after 9/15/12
www.eidebai lly.com
37. Goodwill and Intangibles Impairment
•
Impacts:
•
•
•
Qualitative analysis will need to be documented, rather
than a quantitative calculation (step 1 analysis)
Should reduce time in assessment of goodwill and other
intangible assets
Optional steps in impairment assessment
www.eidebai lly.com
38. Business Combinations
•
ASU 2010-29 – ―Business Combinations‖
•
Expanded disclosure requirements for business
combinations for public entities
•
Effective for first annual period beginning on or
after December 15, 2010
www.eidebai lly.com
39. Business Combinations
•
Disclosure of revenue and earnings of the
combined entity as though the combination
occurred at the beginning of the comparable
period reported (i.e. beginning of PY).
•
Supplemental pro forma disclosure
requirements
•
Material, nonrecurring pro form adjustments
www.eidebai lly.com
40. Fair Value
•
ASU 2011-04 – ―Fair Value Measurement‖
•
Additional explanation of FV measurement and
expanded disclosures
•
Effective for fiscal years beginning after
December 15, 2011
www.eidebai lly.com
41. Fair Value
•
Expanded Disclosures for Public Entities
•
•
Information about transfers between Level 1 and 2
Sensitivity of Level 3 measurements
•
•
•
To changes in unobservable inputs
To interrelationships between unobservable inputs
Level of FV for items not measured at FV, but
required to be disclosed at FV
www.eidebai lly.com
42. Cash Flows – Donated Financial
Assets
•
ASU 2012-05 – ―Statement of Cash Flows‖
•
Donated financial assets should be reported as
operating inflows or, if restricted, financing
activities.
•
Effective for fiscal years beginning after June
15, 2013. Early adoption permitted.
www.eidebai lly.com
43. Joint & Several Obligations
•
ASU 2013-04 – ―Liabilities‖
•
Reporting and disclosure requirements in
certain joint and several liability arrangements.
•
Effective for fiscal years beginning after
December 15, 2013 (2014 for nonpublic). Early
adoption allowed.
www.eidebai lly.com
44. Joint & Several Obligations
•
Entity involved in joint & several liability
arrangement which is fixed at the reporting date
•
•
•
Record amount entity agreed to in its arrangement
with co-obligors.
Plus, any additional amounts expected to be paid on
behalf of co-obligors.
Disclosures of the nature and amounts of total
obligation and other related information.
www.eidebai lly.com
45. Contributed Services
•
ASU 2013-06 – ―Not-for-Profit Entities‖
•
Related to contributed serviced from an affiliate
organization.
•
Effective prospectively for periods beginning
after June 15, 2014. Early adoption permitted.
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46. Contributed Services
•
Recorded at cost of affiliate
•
If considered to over or understate value, an election
may be made for fair value.
• For HC entities, should be reported as an ―equity
transfer‖ (increase in net assets)
• Related to services received from NFP and FP
affiliates
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48. GASB Codification
GASB Statement No. 62 – ―Codification of
Accounting and Financial Reporting Guidance
Contained in Pre-November 30, 1989 FASB
and AICPA Pronouncements‖
•
Effective for periods beginning after
December 15, 2011.
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49. GASB Codification
•
The objective is to incorporate into the GASB
statements, pronouncements issued on or
before November 30, 1989
•
FASB Statements and Interpretations
• Accounting Principal Board Opinions
• Accounting Research Bulletins of the AICPA
•
Removes GASB 20 accounting policy option
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50. GASB Codification
•
Additional Topics Considered
•
Includes sections related to a variety of transactions
• From FASB and AICPA literature
• Applies to governmental activities, business-type
activities, proprietary funds, but not all governmental
funds
•
27 broad transactions were included
•
Has not addressed:
• Governmental combinations – GASBS 69
• Fair value measurement – exposure draft anticipated
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51. GASB Codification
•
Impacts
•
•
•
Cannot make accounting policy option
Need to ensure previous treatments under FASB or
other literature are consistent with GASB 62 or after
If not in GASB, can utilize other guidance (FASB, etc.) or
industry practice, but none are authoritative
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52. Reporting Entity and Component Units
GASB Statement No. 61 – ―The Financial
Reporting Entity: Omnibus an amendment of
GASB Statements no. 14 and no. 34‖
•
Component Units Criteria
•
•
•
Financial Accountability
―Misleading to Exclude‖ the organization from the
financial statements
Effective for periods beginning after June 15,
2012
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53. Reporting Entity and Component Units
•
Financial Accountability
•
•
Primary Government (PG) appoints voting majority of
board
The potential component unit (PCU) if fiscally
dependent
•
•
•
•
Does not set own budget
Others levy taxes or sets rates
Cannot issue bonded debt without approval
Potential for the PCU to provide specific benefits to,
or impose specific financial burdens, on the PG
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54. Reporting Entity and Component Units
•
Provide Specific Benefits To, or Impose
Financial Burdens On…
PG can access PCU’s resources
• PG is legally obligated and/or assumed the obligation
to finance the deficits of, or provide financial support
• PG is obligated for the debt
•
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55. Reporting Entity and Component Units
•
Amendments to the Major Component Unit
Requirements
•
•
Based on the nature and significance of relationship
Blended Component Unit
•
CU is legally separate from the PG, but so
intertwined that is functions like a department of the
PG
•
Amendment – CU total debt outstanding is expected to be
repaid entirely with resources of the PG
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56. Reporting Entity and Component Units
•
Blended Component Unit Reporting
Requirements
•
Clarifies that funds of a blended CU have the same
financial reporting requirements as a fund of the PG
• Equity Interests in CU (formerly Investment Interests)
•
•
Investment, if used to derive income or profit
Requires summarized CU f/s in the notes to the f/s
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57. Reporting Entity and Component Units
•
Impacts:
•
Potential change in entities which qualify and a CU or
blended CU
• Reporting requirements – summarized blended CU
information
• Changes will also impact MD&A
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58. Financial Reporting
GASB Statement No. 63 – ―Financial Reporting
of Deferred Outflows of Resources, Deferred
Inflows of Resources and Net Position‖
•
Effective for periods beginning after December
15, 2011
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59. Financial Reporting
•
Identifies 5 elements that make up a statement
of financial position (balance sheet)
•
•
•
•
•
Assets – resources with present service capacity
that the gov’t presently controls
Liabilities – present obligations to sacrifice
resources that the gov’t has little or no discretion to
avoid
Deferred outflows of resources
Deferred inflows of resources
Net position
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60. Financial Reporting
•
Accounting Equations
•
Governmental activities –
Statement of Net Position
Assets + Deferred Outflows – Liabilities –
Deferred Inflows = Net Position
•
Governmental fund format –
Balance Sheet
Assets + Deferred Outflows = Liabilities –
Deferred Inflows + Fund Balance
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61. Financial Reporting
•
Deferred Outflows of Resources
•
•
•
Consumption of net position by the government that
is applicable to a future reporting period
Positive effect on net position
Deferred Inflows of Resources
•
•
Acquisition of net position by the government that is
applicable to a future period
Negative effect on net position
**Only 2 identified in GASBS 63
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62. Financial Reporting
•
Net Position (previously net assets)
•
Residual of all elements presented in a statement of
financial position – presented in 3 types
• Net investment in capital assets
• Previously, ―investment in capital assets, net of
related debt‖
•
•
Restricted
Unrestricted
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63. Financial Reporting
Statement No. 65 – ―Items Previously Reported
as Assets and Liabilities‖
•
Effective for periods beginning after December
15, 2012
•
Retroactive application by restating financial
statements, if practical, for all periods presented
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64. Financial Reporting
•
Continue to Report as an Asset
•
•
•
Prepayments and Inventory
Circumstances in which a pension plan’s net position
exceeds the total pension liability
Report as a Deferred Outflow of Resources
•
•
Deferred debit amounts resulting from the refunding
of debt – not related to issuance costs
Net balance (debit) of direct loan origination costs,
including any portion related to points, for mortgage
loans held for resale prior to the point of sale
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65. Financial Reporting
•
Report as Outflow of Resources
•
•
•
Debt issuance costs
Net balance (debit) of direct loan origination costs…
Report as a Liability
•
•
Resources received in advance in relation to a
nonexchange revenue transaction
Resources received in advance of an exchange
transaction
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66. Financial Reporting
•
Report as Deferred Inflow of Resources
•
•
Resources received in advance in relation to an
imposed nonexchange transaction
Deferred credit amounts resulting from the refunding
of debt
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67. Financial Reporting
•
Disclosures
•
Details of the deferred amounts, if aggregated
•
•
Only if information is not displayed on the face of the
financial statements
Use of term ―deferred‖ is only allowed to relate to
deferred inflows or outflows or resources
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68. Financial Reporting
•
Impacts
•
Potential change in recording certain transactions
•
•
•
•
Debt refinancing
Property taxes
EHR incentive payments
Change in financial reporting structure – not yet
required, however.
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69. Pension Plans – employer accounting
•
GASB Statement No. 68 – ―Accounting for
Financial Reporting for Pensions‖
•
•
•
Effective for financial statements for fiscal years
beginning after June 15, 2014
Replaces existing guidance related to pension plans
that are administered through trusts or equivalent
arrangements that meet certain criteria
Purpose: Improve accounting and financial reporting
by state and local governments for pensions.
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70. Pension Plans – employer accounting
•
Establishes standards for:
•
•
Measuring and recognizing items in the statement of
net position
Identifies methods and assumptions that should be
used to:
•
Project benefit payments
• Discount projected benefit payments to actuarial
present value
• Attribute that present value to periods of employee
service
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71. Pension Plans – employer accounting
•
Defined Benefit Plans
•
Measurement of liability
•
•
Net pension liability = PV of projected benefit payments to
current active and inactive employees attributed to their past
periods of service minus the pension plan’s fiduciary net
position
Actuarial valuations liability required at least every two years
• If not on report date, roll-forward procedures required
• Earlier actuarial valuation must be performed within 30
months and 1 day prior to the most recent year-end.
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72. Pension Plans – employer accounting
•
Projections of Benefit Payments
•
•
Based on benefit terms and legal agreements
existing at the measurement date.
Discounted to their actuarial present value using the
single rate that reflects
•
•
A long-term expected rate of return on plan investments
A tax-exempt, high-quality municipal bond rate
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73. Pension Plans – employer accounting
•
Single and Agent Employer Plans
•
Recognize a liability equal to the Net Pension Liability
•
•
Measured as of a date no earlier than the end of the
employer’s prior fiscal year (the measurement date).
Pension expense = changes in the net pension
liability
•
•
•
•
Current-period service cost
Interest on total pension liability
Changes of benefit terms
Projected earning on the pension plan’s investment included
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74. Pension Plans – employer accounting
•
Single and Agent Employer Plans
•
Notes to financial statements
•
•
•
•
•
Benefits provided
Number of classes of employees
Sources of changes in the NPL for the current year
Significant assumptions and other inputs used to calculate
TPL
Date of actuarial valuation used in determination
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75. Pension Plans – employer accounting
•
Single and Agent Employer Plans
•
Required supplementary information
•
Present for each of the 10 most recent years
• Sources of changes in the net pension liability
• Components of net pension liability
• Actuarially determined contributions or statutorily or contractually
required contribution rates, contributions to the plan and related
ratios
•
Notes to the required supplementary information
• Significant methods and assumptions used in calculating the
actuarially determined contributions
• Factors that affect trends
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76. Pension Plans – employer accounting
•
Cost-Sharing Plans
•
•
•
Recognize liability for proportionate share of NPL.
Employer’s portion of NPL is determined consistently
with contributions.
Recognize pension expense and deferred outflows
and inflows of resources relation to proportionate
share.
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77. Pension Plans – employer accounting
•
Cost-Sharing Plans
•
Recognized in pension expense in a systematic and
rational manner of a closed period
•
•
Changes in the employer’s proportion of the collective NPL
Differences between the employer’s contributions and
proportionate share of the total of contributions from
employers included in the collective NPL during the
measurement period.
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78. Pension Plans – employer accounting
•
Defined Contribution Pensions
•
Pension expense
•
•
•
Contributions to employees’ accounts
Net of forfeited amounts that are removed from employees’
accounts
A change in the pension liability is recognized for the
difference between amounts in expense and amounts paid
by the employer to the plan
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79. Pension Plans – employer accounting
•
Defined Contribution Pensions
•
Notes to financial statements
•
•
•
Descriptive information
Contribution rates and how they are determined
Amounts attributed to employee service and forfeitures for
the current period
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80. Other GASB Updates
GASB Statement No. 64 – ―Derivative
Instruments: Application of Hedge Accounting
Termination Provisions – an amendment to
GASB Statement No. 53‖
•
Effective for periods beginning after June 15,
2011
•
Objective: clarify whether an effective hedging
relationship continues after the replacement of
a swap counterparty
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81. Other GASB Updates
GASB Statement No. 67
•
•
•
Effective for financial statements for fiscal years
beginning after June 15, 2013
Replaces current guidance related to pension plans
that are administered through trusts or equivalent
arrangements that meet certain criteria
Purpose: improve the usefulness of pension
information included in the general purpose external
financial reports of state and local governmental
pension plans for making decisions and assessing
accountability
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82. Lease Proposal
•
Proposed ASU was issued in August 2010
• Announced in July 2011 it will be re-exposed
• June 13, 2012 – IASB and FASB last agreed on
additional changes to draft
• Released Exposure Draft – May 16, 2013
•
Effective date, if passed (which is expected),
???
•
Expected 2015 or 2016
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83. Lease Proposal
•
Lessee accounting
•
Leases over 1 year will be recorded on the balance
sheet at present value of lease payments
•
•
•
Right-of-use asset and liability
Recorded as separate assets and liabilities on the balance
sheet
Lease term
•
―The non-cancellable period for which the lessee has
contracted with the lessor to lease the underlying asset,
together with any options to extend or terminate the lease
when there is a significant economic incentive for an entity to
exercise an option to extend the lease, or for an entity not to
exercise an option to terminate the lease.‖
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84. Lease Proposal
2 Types of Leases
•
Type A – other than property
•
•
Discount on lease as interest and amortization of asset
separately
Type B – property – land and/or building or part of a
building
•
•
•
Discount on the lease
Amortization of asset
Total to equal single ―lease cost‖ on a straight-line basis
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85. Lease Proposal
•
Impacts
•
•
Additional assets and liabilities on the balance sheet
If treated as long-term debt:
•
•
•
•
•
Decreases debt service coverage ratio (negative)
Increases long-term debt to capitalization ratio (negative)
Increases days cash on hand (positive)
Potentially significant amount of time identifying and
recording existing lease contracts
Allows for different leasing options as
treatment will be the same if over 1 year
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86. Proposed Single Audit Changes
•
Proposed changes to single audits – no
effective dates, but preliminarily expected to be
6/30/14
•
Single audit threshold to increase from
$500,000 to $750,000
•
Type A/B program determination to increase
from $300,000 to $500,000
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87. Proposed Single Audit Changes
•
Change in major program determination
•
High-risk Type A program requirements
• Small Type B programs considered to be 25% of Type A/B
program threshold
• Reduction in high-risk Type B programs required to be
tested from 50% of Type A’s selected to 25%
•
Percentage of coverage to reduce from 50% (normal)
and 25% (low-risk) to 40% and 20%, respectively
•
Low-risk auditee modifications
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88. Proposed Single Audit Changes
•
Increased detail in reported audit findings
•
Increase in questioned cost threshold for reporting from
$10,000 to $25,000
•
Streamline existing OMB circulars
•
A-21, A-87, A-89, A-102, A-110, A-122, A-133 into one
document
• A-50 superceded
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89. Proposed Single Audit Changes
•
Change in compliance requirements to be tested – from
14 to 6
1. Activities Allowed or Unallowed and Allowable
Costs/Cost Principles (potentially also including
period of availability and matching)
2. Cash Management
3. Eligibility
4. Reporting
5. Subrecipient Monitoring
6. Special Tests & Provisions (removed requirements
may show up in this area, however)
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Differing accounting conceptsPrimarily for PPS facilities
Colorado – attest to the adoption, implementation, or upgrade of a certified EHR 3 payments – 50% in year 1; 40% in year 2; 10% in year 3
“Reasonable assurance” funds will be received and conditions for payment metCliff or ratable method – when is assurance supported?Not-for-profit hospitals – in performance indicator; generally operating revenue, separate from patient revenue, but dependent on facts/circumstancesGovernment hospitals – operating revenues, separate from patient revenueInvestor-owned hospitals – operating revenues, separate from patient revenue
“Gain contingency” accounting model for income recognitionDelays recognition compared to AICPA/HFMA modelHospital Corporation of America (HCA) treated as, “when its eligible hospitals have demonstrated meaningful use of certified EHR technology for the appropriate period and the cost report information for the full cost report year that will determine the final calculation of the HITECH payment is available.”
Final calculation means end of fiscal year after attestationRevenue deferral over life of asset or 4 years
Final calculation means end of fiscal year after attestationRevenue deferral over life of asset or 4 yearsBased on matching concept (i.e. depreciation expense on qualified EHR assets will be expensed in future years without related reimbursement)Consider 20% incentiveDifference between Medicare and Medicaid for CAHs
MIC – Medicaid Integrity ContractorMAC – Medicare Administrative ContractorZPIC – Zone Program Integrity Contractor previously program safeguard contractor & Medicare prescription drug integrity contractor
Communications:
Does not require a split – for example, elective surgeriesPublic entities – conduit debtPeriods beginning after December 15, 2012
Including “bad debts related to receivables from patient service revenue if the entity only recognizes revenue to the extent it expects to collect that amount.”
GASB History FASB had the standard setting authority for gov’t until 1989 Governments were required to implement all GASB pronouncements and FASB pronouncements issued prior to Nov. 1989 which didn’t conflict with new GASBsIn 2009, FASB adopted Accounting Standards Codification, which made the old FASB standards obsoleteGASB 62 incorporates all relevant FASB and AICPA standards issued prior to 1989Allowed enterprise funds and business type activities to apply post November 30, 1989 FASB Statements and Interpretations – as long as they didn’t conflict with or contradict GASB StatementsGASB has since issued standards for most topicsFor financial reporting issues not yet addressed by GASB, preparers could consult FASB or other literature for guidance even though it is not authoritativeNo. 20 allowed governmental financial statements and similar entities in the private sector to be comparableGovernmental entities did so as they GASB hadn’t addressed these issues yetMay still with to consult FASB literature even though not considered authoritative
Statement was to adopt the accounting and financial reporting requirements of FASB and the AICPA pronouncements in pre 1989 formA few modifications to the language to update for the effects of the governmental environmentNot intended to establish new reporting requirementsBroad TransactionsCapitalization of interest cost provisionsRevenue recognition for exchange transactionsStatement of net assets classifications
Statement was to adopt the accounting and financial reporting requirements of FASB and the AICPA pronouncements in pre 1989 formA few modifications to the language to update for the effects of the governmental environmentNot intended to establish new reporting requirementsBroad TransactionsCapitalization of interest cost provisionsRevenue recognition for exchange transactionsStatement of net assets classifications
Financial Accountability – PG is accountable if it appoints voting majority of the organization’s governing body and is able to impose its will on the at organization or there is a potential for the organization to provide spe
Component Unit – legally separate entity where the elected officials of the primary government are financially accountable or the component unit’s exclusion would render the financial statements misleading or incompleteMisleading to exclude – “the PG , may determine, through exercise of professional judgment, that the inclusion of an organization that doesn’t meet the financial accountability criteria is necessary in order to prevent the reporting entity’s financial statements from being misleading””Professional judgmentEmphasizes the consideration rather than required inclusion
Reporting requirements – major component unit 1. presenting each major CU in a separate column in the reporting entity’s statements of net assets and activities 2. Including combining statements of major component units 3. Presenting condensed financial statements in the notes to the reporting entityServices provided to the citizenry are considered essential to the financial statement usersSignificant transactions with the PGSignificant financial benefit or burden relationship with PGRemoved requirement that the determination include consideration of each component unit’s significance relative to other component units.Exclusive benefit – financing servicess provided solely to the PG
Exclusive benefit – financing servicess provided solely to the PGNotes to financials:Brief description of component unit and relationship to the PGDiscussion of the rationale for including component unit and whether it is discretely presented, blended, or included in the fiduciary find financial statement
1. Should be in effect for all entities now
Statements 53 – accounting for derivative investments and 60 – reporting for concession arrangements, require deferralsLater, we will discuss other deferrals for statements 67 and 68 related to pensions
DisclosuresDetails of the different types of deferred amounts in the notes to the f/s if significant components of the amounts are obscured by aggregationNeeded only if the information is not displayed on the face of the f/sDifference between a deferred outflow of resources or deferred inflows of resources and the balance of the related asset or liability is significant, an explanation of that effect on its net position in the notes should be provided
Net investment in capital assetsNet capital assets Less: outstanding debt related to capital assets Adjusted for: deferred outflows and deferred inflows of resources related to the acquisition, construction or improvement of capital assets or related debt Less: any unspent debt proceeds or deferred inflows of resources related to debtRestrictedRestricted, less liabilities and deferred inflows of resources related to those assetsUnrestrictedNet amounts of assets, deferred outflows of resources, liabilities, and deferred inflows of resources that are not included in the determination of net investments in capital assets or the restricted component of net position
The purpose of this statements is to establish accounting and financial reporting standards that reclassify, as deferred outflows of resources or deferred inflows of resources, certain items that were previously reported as assets and liabilities and recognizes, as outflows of resources or inflows of resources, certain items that were previously reported as assets and liabilities.Concepts statement 4, Elements of financial statements – introduced these conceptsPreviously only statement 53 – accounting and financial reporting for derivative instruments and statement 60 – concession arrangements were applicable
Prepayments and Inventory – board determined they are an asset as the entity controls the use of the prepaymentsPension – the board deliberated on this one as the assets are not under direct control but they could be use for future benefit accruals
DisclosuresDetails of the different types of deferred amounts in the notes to the f/s if significant components of the amounts are obscured by aggregationNeeded only if the information is not displayed on the face of the f/sDifference between a deferred outflow of resources or deferred inflows of resources and the balance of the related asset or liability is significant, an explanation of that effect on its net position in the notes should be provided
DisclosuresDetails of the different types of deferred amounts in the notes to the f/s if significant components of the amounts are obscured by aggregationNeeded only if the information is not displayed on the face of the f/sDifference between a deferred outflow of resources or deferred inflows of resources and the balance of the related asset or liability is significant, an explanation of that effect on its net position in the notes should be provided
Effective for pension plans that are administered through trusts with the following characteristics;Contributions and earnings are irrevocableAssets are dedicated to providing pensions to plan membersLegally protected from creditors of employers, non-employers contributing entities, plan administrator and plan members (if the plan is a Defined Benefit Plan)
Procedures to roll forward amounts from a previous actuarial valuation are required if not completed on measurement date
Long-term expected rate of return - to the extent that the plan’s fiduciary net position is projected to be sufficient to pay benefits and plan assets are expected to be invested using a strategy to achieve that rate of returnTax-exempt, high-quality municipal bond rate - to the extent that the conditions for use of the long-term expected rate of return are met.
Assignment – swap agreement is amended to replace an original counterparty, but all the other terms of the swap are the sameIn-substanceCounterparty is replacedOriginal swap is ended and the replacement swap in entered the same dateTerms that affect changes in fair values and cash flows in the original and replacement swaps are identicalAny difference in exit price of old and entry price of new is attributable to the based on a computation specifically permitted under the original swap agreement
Effective for pension plans that are administered through trusts with certain considerations